Relationship between arteriovenous fistula cannulation practices and dialysis adequacy: A prospective, multicenter study

Abstract

Background Successful arteriovenous fistula cannulation ensures maximum patient benefit in the haemodialysis procedure. Objective The aim of this study was to determine the effect of various cannulation methods used for arteriovenous fistulas on dialysis adequacy. Design It is a descriptive, cross-sectional and multicenter study. Participants A total of 164 dialysis patients from four dialysis centers were included. Measurements Data were collected by determining patients' characteristics and the arteriovenous fistula cannulation method used, in addition to recording the Kt/V and urea reduction ratio values to evaluate dialysis adequacy. The mean Kt/V and urea reduction ratio values over 3 months after dialysis initiation were used. This trial is registered with , NCT04270292. Results Cannulation with the puncture method was used in 53% of the patients; the fistula needles were inserted in the antegrade direction in 43.9% of the patients; the arterial needle was rotated after fistula needle placement in 63.4% of the patients; and the arterial and venous needles were on the same vascular line in 15.2% of the patients. Placement of the fistula needle in the antegrade direction increased the Kt/V value 0.164 times (95% confidence interval: 0.002-0.212, p = .047). Conclusion Antegrade placement could be a factor influencing dialysis adequacy. We suggest antegrade interventions to the fistula to maximize the patient benefit from the haemodialysis treatment.